For each area below, we've explained the problem and outlined common symptoms. Then we've described "state of the art" treatment methods. Although your problems may feel overwhelming to you, there are counseling approaches that can help you restore balance and happiness to your life. ››  Normal Life Crises ››  Workplace Problems ››  Trauma And PTSD Normal Life Crises: Transitions, Loss, Change Description of the Problem Sometimes perfectly healthy people go through tumultuous, difficult periods simply because of – well, life. The formal psychiatric term for this kind of problem is "Adjustment Disorder", but what this really means is that some event or situation has thrown you temporarily off balance. Your aging parent may die: even though this is an expected event, you may find your grief is overwhelming. You or a loved one may be faced with a chronic illness; this is not a ‘neurosis,’ but it can be so upsetting that you find yourself depressed and irritable. A relationship has just ended; even though you may be glad it is over, you still ruminate over the past and feel painfully lonely. Even positive life changes can be stressful: you’re attending the college of your choice, but it’s a thousand miles from home and you feel a bit frightened; you are moving in with a partner you love, but suddenly find yourself fighting with each other over nothing. Any life transition or loss can precipitate symptoms that look like depression or anxiety, even in someone who is the paragon of mental health. When this happens, you will surely ‘get through’ the situation without counseling – but the support of psychotherapy can smooth your response and hasten your return to a normal, balanced state of mind. Treatment Approaches If you come to therapy because of a reaction to a life transition or loss, treatment will usually be brief – sometimes only a few sessions – and you will rarely be referred for medication. Instead, counseling will focus on allowing you to vent your feelings and have them validated, and, when possible, find practical solutions to the life crisis that faces you. Often, we may suggest a support group, particularly if your problem is bereavement or facing chronic or terminal illness. At other times, we’ll recommend books, articles, or websites that can give you useful information – ‘bibliotherapy.’ You may find that just having the support of another person gives you more strength to face a difficult situation. You can get that from your IPG counselor, but he or she will also guide you to places you gain that support outside of therapy, as well. Sometimes therapy will reveal repetitive patterns that exacerbate your reaction to a stressful life event; for example, a relationship loss may feel overwhelming because it triggers feelings from past ended relationships, or a geographic move may remind you of a painful childhood transition. Other times, you will find you have an exaggerated response to trouble because you blame yourself or feel you are being punished; you might be uncomfortable with success because you are afraid you don’t deserve it. Therapy can help you uncover these deeper dynamics so that you can genuinely change a problem into an opportunity for growth. Workplace Problems Description of the problem Over the last decade, it has become increasingly common for people to find their jobs or careers stressful and unsatisfying. In part this is related to the current economic crisis which has, for the first time in recent history, left many white-collar and professional people jobless, often for extended periods. In addition, corporations that once could be counted of to take care of loyal employees now ‘force-reduce’ frequently and without regard to years of service. The life-long ‘company man/woman,’ is now an anachronism. It is no wonder that in this atmosphere of fear and uncertainty workplace stress and work-related problems have grown, and with them the health problems associated with high stress: depression, anxiety, high blood pressure and coronary heart disease, gastrointestinal problems, and a host of others. If you find yourself dreading Monday mornings, worrying constantly about job or finances, feeling hopeless about your career, or experiencing increasing tension and irritability during the work day, your problems are probably work-related. At an extreme, you may experience so much difficulty getting along at work that your employer mandates counseling for you, or you may be unemployed for so long that you simply give up looking for a job. Treatment Approaches For many years IPG has had contracts with a variety of employers to provide what is called Employee Assistance Counseling, or EAP services. Because of this experience, we are very familiar with corporate structures and the typical problems people experience at work. Our knowledge of the hierarchies and power dynamics in the work place enables us to give you practical advice. We can help you navigate difficult work relationships such as demanding bosses or coworkers, and manage other work place stresses like overwhelming or unrealistic workloads.We know better than to tell you to share your feelings with your tyrannical boss, or 'open up' to your coworkers about personal problems. Our goal is to use our corporate and business experience to help you find pragmatic strategies for your problems, usually in 10 sessions or less. If you have been mandated by your employer to seek counseling, we know how to help you solve your employment problem and protect your privacy and confidentiality at the same time. Some of the reasons an employer might mandate EAP counseling include: obtaining a positive result on a workplace drug screen test; excessive absences or other disciplinary issues; inability to get along with bosses or co-workers; accusations of verbal, physical, or sexual harassment. Again, because we have had so much EAP experience, we know the ins and outs of work-mandated treatment, so we can skillfully be your counselor and advocate while helping you satisfy the requirements of your employer. We know the legalities and limits of confidential information in these situations. We can diplomatically deal with any requests for information from your employer, while only confirming or denying that you have been attending treatment and following your treatment plan without providing any personal information about you to your employer. Sometimes your ‘work-related problem’ is that you are stuck in a situation you can neither change nor leave: you have a job you hate but you have to stay in it, you may be doing all you can to look for work but still jobless. In these cases, our training in stress-management techniques can help you weather these bad periods with minimum negative consequences to your health or state of mind. For more information on this, see our Wellness page. Trauma and Post Traumatic Stress Disorder Description of the Problem Sometimes people are survivors of trauma, painful life events that are outside the range of normal experience and beyond the coping abilities of most humans. When people are subjected to such events, it is normal to have emotional repercussions either immediately afterwards or within months of the event. While we are skilled at helping people in such situations - for example, many IPG therapists counseled survivors of 9/11 –it is more common that people come for treatment for emotional reactions to events long past that may even have been buried from memory. The trauma that has caused the difficulty may have been a one-time occurrence, such as rape, or it may have been ongoing, like sexual, physical, or emotional abuse in childhood, or domestic violence. People whose reaction to trauma lasts abnormally long, or who have delayed reactions, may be suffering from Post Traumatic Stress Disorder. PTSD may emerge days or months after the event, or, particularly with childhood trauma, may take years to manifest. If you suffer from PTSD, you may have otherwise unexplainable bouts of insomnia, depression, anxiety, nightmares and flashbacks of past painful events. You might be plagued by intrusive thoughts or images of the trauma. You may also overreact to events or situations that are similar to the trauma you have experienced, and you may not even recognize these "trigger" situations. These symptoms can completely disrupt your life and your relationships. Treatment Approaches The treatment of PTSD varies depending upon a number of factors, including the intensity of acute symptoms in the survivor, and whether the trauma was single-episode or ongoing. If you are in acute distress, coping with symptoms is the first priority. As with other mood disorders, PTSD may respond at least partially to antidepressant medication, and if we think you might benefit, we will send you for a medication evaluation. In addition, we will help you learn relaxation techniques to calm yourself when intense symptoms arise, i.e., help you create a ‘safe space’ within you that you can access yourself and that will help alleviate acute anxiety. Moreover, you can learn to predict triggers, avoid them when practical, or, if they must be faced, learn gradually, through desensitization, to approach triggers without fear. Many PTSD sufferers benefit enough from symptom reduction and preventative techniques to need no other treatment. At IPG, we do not believe that all trauma survivors need to ‘re-live’ their experiences to be healed; sometimes, if acute distress is healed, the mind heals itself over time. Both the American Psychological Association and The American Psychiatry Association recommend EMDR, or "rapid eye movement" therapy, as a first-line treatment for PTSD. Dr. Nichols and several other clinicians are trained to facilitate EMDR which, when appropriate, is extremely short-term and both time and cost efficient. Whether or not EMDR is used, trauma survivors sometimes need to re-visit their trauma by talking about it and sorting out the upsetting and sometimes conflicting feelings they have and the beliefs surrounding the trauma (e.g. self-blame) that prevent healing and "letting go." While trauma is rarely entirely forgotten, treatment for PTSD can allow you to process the event or events so that memories do not disrupt your day-to-day life and your emotions are not overwhelming and debilitating.